Sorry I didn't include labs very well, it was a bad post from my phone. I'm 30 years old. I've been on suboxone almost 10 years, no steroid use, no other medications. Currently I take ~2mg daily, it was maybe 3mg 6 months ago. No medical conditions.
For the last couple of years, I've been feeling fatigued, mentally less sharp. I cut back my suboxone (which always made me feel manic if anything), no change, I started exercising regularly, lost about 30 pounds, and didn't really feel much better. Maybe a year ago my PCP ran labs, everything "normal" except testosterone, which was ~250.
I then saw a urologist, that ran more labs which I'll include below. T was ~270 a He prescribed angrogel and ran an MRI due to high prolactin, which was clean.
Here are my labs from last week, this looks to be everything he tested for (no dhea-s. Format is range then my reading):
TESTOSTERONE,TOT SRM 241.00 - 827.00 ng/dL 1070.60
ESTRADIOL <47 pg/mL 448 (does something this high even make sense, is this even possible?)
PROLACTIN 2.6 - 13.1 ng/mL 8.8
FREE T3 2.2 - 4.3 pg/mL 3.3
TSH 0.340 - 5.600 uIU/mL 1.758
THYROXINE,FREE 0.57 - 1.25 ng/dL 0.85
ANTI THYROGLOBULIN <4
ANTI TPO 0 - 9 IU/mL 0
PSA,SERUM 0.0 - 4.0 ng/mL 0.8
FERRITIN 24 - 336 ng/mL 56
HGB A1C <5.7 % 4.8
A1c values of 5.7-6.4 indicate an increased risk for diabetes mellitus. A1c
values of greater than or equal to 6.5% are diagnostic of diabetes mellitus.
The ADA recommends A1c values of less than 7% as the goal for diabetic
EST AVG GLUCOSE 91
Estimated Avg. Glucose is calculated from the HgbA1c
SODIUM 136 - 144 mEq/L 140
POTASSIUM 3.6 - 5.2 mEq/L 4.3
CHLORIDE 101 - 111 mEq/L 99
TOTAL CO2 22 - 32 mEq/L 33
ANION GAP 5 - 15 8
GLUCOSE 60 - 99 mg/dL 83
Normals are for fasting, no normals for random.
UREA NITROGEN 8 - 20 mg/dL 25
CREATININE 0.5 - 1.5 mg/dL 1.0
CALCIUM 8.9 - 10.3 mg/dL 9.6
PROTEIN, TOTAL 6.1 - 7.9 g/dL 7.2
ALBUMIN, S 3.5 - 4.8 g/dL 4.5
GLOBULIN 2.3 - 3.8 g/dL 2.7
A/G RATIO 1.0 - 2.0 1.7
BILIRUBIN, TOTAL 0.3 - 1.2 mg/dL 0.7
AST(GOT) 15 - 41 U/L 38
ALT (GPT) 17 - 63 U/L 38
ALK PTASE 38 - 126 U/L 52
EGFR >60 mL/min 88
EGFR (BLACK) >60 mL/min 106
Here are my labs pre androgel about 6 months ago at the end of February (format is my reading then range, note test reading are in pg/ml):
LH 4.2 m[iU]/mL 1.7-8.6
FSH 5.4 m[iU]/mL 1.5-12.4
PROLACTIN 16.8 ng/mL 4.0-15.2
AFPTUMORMRKR 1.4 ng/mL 0.0-8.3
QNTBETAHCG <2 mIU/mL [iU]/L 0-3
SHBG 20.5 NMOL/L 16.5-55.9
TESTOS TOTAL 2760.0 pg/mL Units converted. See lab report for original value.
TESTO, FREE 6.3 pg/mL 9.3-26.5
So my prolactin has dropped considerably, not sure if that is of any consequence.
My endocrinologist stated specifically that suboxone decreases testosterone, most research I've done seems to jive with this. Perhaps some see increased testosterone when on it, I certainly did not. I believe he said it was a result of how it acts on LH and FSH, though not sure.
Upon first starting TRT, I was given testim samples, which made me feel great, slept better, much better libido, felt more rested, clearer head, etc. These were dosed at 50mg daily IIRC. Insurance didn't cover it though, so I was given androgel. This didn't seem to have the same effect, so the urologist upped the dose, 60mg daily, or 3 pumps. It didn't seem to have an effect.
I have put on muscle, but I'm not sure if it's an abnormal amount for 6 months, maybe 10-15lbs, and I'm a newbie to lifting in the last 12 months. Again, not extremelyu concerned about the anabolic effects of TRT, just want to be feel better, and get normal results in the gym.
The endocrinologist wants to use clomiphene, even after seeing the new labs. I said I was extremely uncomfortable with a treatment plan that didn't directly address my e2 levels. Originally, he didn't even think running e2 was important, and only ran them at my request. I've asked him to use an AI instead of clomiphene, paired with reducing my androgel, to get e2 under control, then re-evaluate.
I have to give a big thanks to people here, through lurking, and checking out threads, I've been able to learn just enough to ask better questions (like can you run my e2 levels).
Already I'm trying to get in to see another endocrinologist through the UW clinics, but it took me 2 months just to get in to see this guy.
In the mean time, what if anything can I do to get e2 down? I think an AI is an obvious place to start, but I'd really rather have this prescribed, than take 2 weeks waiting for a questionable non-pharmacy AI.